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External eating  mediates the influence of sensitivity to reward on the unhealthy snack pattern of adolescents independent of food availability at home or at school

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Abstract
Purpose: Previous research found that an increased Reward Sensitivity (RS) in adolescents was positively associated with more unhealthy snack intake. Individuals with a high RS may be more sensitive and reactive to rewarding food items in the environment, i.e. fat- and sugar-rich food products such as energy-dense snacks. Thus adolescents with a high RS might be tempted to eat in response of environmental cues and as such develop an external eating style. Firstly it was aimed to assess if RS is associated with unhealthy snack intake in adolescents aged 14-16 years old and if this relation is mediated by external eating. Secondly we wanted to investigate if the availability of unhealthy snacks at home or at school moderated the RS-external eating association, as it is expected that an obesogenic environment would enhance development of an external eating style in high RS adolescents. Methods: Self-reported data on snacking behaviour, availability at home and at school of unhealthy snacks, RS (BAS DRIVE) and external eating (DEBQ) of Flemish adolescents (n=1104, mean age = 14.7±0.8 years; 50.9% boys; 18.0% overweight) were collected via a cross-sectional survey. Multilevel moderated mediation analyses were conducted using Generalized Structural Equation Modeling (path analysis) in four steps (four GSEM models) in STATA version 13. Gender and zBMI were added as covariates, as these were significantly correlated to the outcome. Results: Model 1 showed that RS was positively associated to unhealthy snack intake (b=26.83, p<0.001). Model 2 indicated a partial mediation effect of external eating (a*b=6.53, c’=24.70, p<0.001). In model 3 and 4 no moderation of availability at home or at school on the path between RS and external eating was found. Conclusion: Our findings indicate that the consumption of unhealthy palatable snacks is determined by the development of an external eating style coming from an increased RS. However a high availability of unhealthy snacks at home or at school did not enhance this development. Thus adolescents seem to develop an external eating style fostered by a high RS independent of their home or school environment. Future interventions in adolescents should acknowledge differences in RS and related eating styles.

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Chicago
De Cock, Nathalie, Wendy Van Lippevelde, Lien Goossens, Bart De Clercq, Jolien Vangeel, Carl Lachat, Kathleen Beullens, et al. 2015. “External Eating  Mediates the Influence of Sensitivity to Reward on the Unhealthy Snack Pattern of Adolescents Independent of Food Availability at Home or at School.” In 2015 Annual Meeting of the International Society for Behavioral Nutrition and Physical Activity.
APA
De Cock, N., Van Lippevelde, W., Goossens, L., De Clercq, B., Vangeel, J., Lachat, C., Beullens, K., et al. (2015). External eating  mediates the influence of sensitivity to reward on the unhealthy snack pattern of adolescents independent of food availability at home or at school. 2015 Annual meeting of the International Society for Behavioral Nutrition and Physical Activity. Presented at the 2015 Annual meeting of the International Society for Behavioral Nutrition and Physical Activity (ISBNPA 2015).
Vancouver
1.
De Cock N, Van Lippevelde W, Goossens L, De Clercq B, Vangeel J, Lachat C, et al. External eating  mediates the influence of sensitivity to reward on the unhealthy snack pattern of adolescents independent of food availability at home or at school. 2015 Annual meeting of the International Society for Behavioral Nutrition and Physical Activity. 2015.
MLA
De Cock, Nathalie, Wendy Van Lippevelde, Lien Goossens, et al. “External Eating  Mediates the Influence of Sensitivity to Reward on the Unhealthy Snack Pattern of Adolescents Independent of Food Availability at Home or at School.” 2015 Annual Meeting of the International Society for Behavioral Nutrition and Physical Activity. 2015. Print.
@inproceedings{8044083,
  abstract     = {Purpose: Previous research found that an increased Reward Sensitivity (RS) in adolescents was positively associated with more unhealthy snack intake. Individuals with a high RS may be more sensitive and reactive to rewarding food items in the environment, i.e. fat- and sugar-rich food products such as energy-dense snacks. Thus adolescents with a high RS might be tempted to eat in response of environmental cues and as such develop an external eating style. Firstly it was aimed to assess if RS is associated with unhealthy snack intake in adolescents aged 14-16 years old and if this relation is mediated by external eating. Secondly we wanted to investigate if the availability of unhealthy snacks at home or at school moderated the RS-external eating association, as it is expected that an obesogenic environment would enhance development of an external eating style in high RS adolescents.
Methods: Self-reported data on snacking behaviour, availability at home and at school of unhealthy snacks, RS (BAS DRIVE) and external eating (DEBQ) of Flemish adolescents (n=1104, mean age = 14.7{\textpm}0.8 years; 50.9\% boys; 18.0\% overweight) were collected via a cross-sectional survey. Multilevel moderated mediation analyses were conducted using Generalized Structural Equation Modeling (path analysis) in four steps (four GSEM models) in STATA version 13. Gender and zBMI were added as covariates, as these were significantly correlated to the outcome. 
Results: Model 1 showed that RS was positively associated to unhealthy snack intake (b=26.83, p{\textlangle}0.001). Model 2 indicated a partial mediation effect of external eating (a*b=6.53, c{\textquoteright}=24.70, p{\textlangle}0.001). In model 3 and 4 no moderation of availability at home or at school on the path between RS and external eating was found. 
Conclusion: Our findings indicate that the consumption of unhealthy palatable snacks is determined by the development of an external eating style coming from an increased RS. However a high availability of unhealthy snacks at home or at school did not enhance this development. Thus adolescents seem to develop an external eating style fostered by a high RS independent of their home or school environment. Future interventions in adolescents should acknowledge differences in RS and related eating styles.},
  author       = {De Cock, Nathalie and Van Lippevelde, Wendy and Goossens, Lien and De Clercq, Bart and Vangeel, Jolien  and Lachat, Carl and Beullens, Kathleen and Eggermont, Steven and Maes, Lea and Braet, Caroline and Deforche, Benedicte and Kolsteren, Patrick and Van Camp, John},
  booktitle    = {2015 Annual meeting of the International Society for Behavioral Nutrition and Physical Activity},
  language     = {eng},
  location     = {Edinburgh, Scotland, UK},
  title        = {External eating~ mediates the influence of sensitivity to reward on the unhealthy snack pattern of adolescents independent of food availability at home or at school},
  year         = {2015},
}